Brothers Doug and David Blank discuss the issues of the day. One is a Christian, ER doctor, and member of the tea party; the other is an atheist, computer scientist, and liberal arts professor. How did this happen, and what do they have to say?

Wednesday, April 13, 2016

The Art of the Argument

Doug:
So here's the context of this week's discussion: David would like to discuss a "position paper" but it looks to me like this is just a small group of people trying to inject their political opinion into a scientific argument. I've agreed to discuss this, but in no way want to give the impression that this is anything other than what it might be (pure political opinion). So, David's proposed title "Gender Ideology Harms Children- It's Official" has been changed, and now we start with David's introduction:David:Well, you certainly are starting off poorly, and in bad faith. Does this mean that from now on, we'll be starting the blog by stating the other brother's discussion is complete hogwash, and not deserving of our time, but, well, let's just go along with it, but with the understanding it's just foolish and a waste of everyone's time? And just to emphasize the fact, let's change the heading to a topic I feel represents my total dismissal of the topic my brother introduced.Doug:
Ok, that wasn't David's introduction. And I want to use your argument as an example of how to make an argument. Here it is:

David:You may prefer not to address the topic, but it remains true that...Doug:And that wasn't his intro... here it is:David:...in a stunning science-grounded report, the American College of Pediatricians published a position paper last month taking a strong stand against the increasingly popular notion of promoting gender ideology among children. In fact, the group finds that the most recent studies indicate that gender-identity dysphoria, and the political desire to promote it, harms children.Doug:Ok, so let's break down this description. In case this is a foreign phrase, a "position paper" is:

an essay that presents an opinion about an issue , typically that of the author or another specified entity; such as a political party. Position papers are published in academia, in politics, in law and other domains. -- wikipedia

So these are clearly a separate category from scientific papers that have research and conclusions based on data. Position papers could be described as "stunning" if there was something unexpected revealed, such as an Oil and Gas position paper came out in favor of tighter environmental controls. You used the word "published" but this isn't published at all, unless our blog is also "published". The position paper just appears on their web site.David:Multiple professional groups assemble scientific papers to reach best-practice conclusions, and then produce position papers based on that research. This is the essence of creating best-practice guidelines. Perhaps continually improving quality is only something we use in medicine, and not in the academic setting.Doug:Sure, this paper represents the best medicine has to offer. But let's get to the paper and authors. The "American College of Pediatricians" sounds very professional. I have no idea what "gender ideology" is. But whatever it is, David had indicated (before editing) that liberals are going to hate it. I believe you said that "liberals will have a stroke." But you edited that out. That's too bad, because I wanted to look at the style of your argument. This was a not-so-subtle hint to allow you to see the paper in the "right perspective." Ok, so continue:

David:
Wow. So far you have started the discussion by first, totally dismissing the paper as nonsensical tripe, that no one should have to suffer through, and then attack the messengers presenting the paper. All of this before the discussion has even started. Did the spirit of Saul Alinski take over my brother? Or is the topic so discomforting that you feel a need to squash it before any discussion of the facts can even get presented? "Nothing to see here. The messenger is a crazy loon! Just walk away before he gets violent! Don't listen to him, because he's a crazy loon!"

So, you may not have had a stroke because of the subject of the discussion, but you've pulled out every Alinsky trick to change the subject from the actual subject.

Doug:Who is "Saul Alinski" again? Oh, right, you mean Saul Alinsky who "conservative author William F. Buckley, Jr. said in 1966 that Alinsky was 'very close to being an organizational genius'." He must be a real demonized person on the right, and mentioned as a dog whistle.

David:
Ah, now you're even diverting attention to typos, without giving me a chance to correct them. Your style of argument leaves a bit to be desired. So far, you've tried several means to avoid the topic altogether. Readers who follow liberal discussions might want to note that these tactics are often followed by the Left. Remember, Hillary Clinton wrote her thesis on Saul Alinsky's work. I always laugh when you pretend to have never heard of him.

Now, if you're actually ready to talk about the subject at hand....The American College of Pediatricians is a group of board-certified pediatricians. It was founded by the former president of the American Academy of Pediatrics, the most populous of Pediatric professional associations. It has members from 47 states. One of the contributors to this position paper is Dr. Paul McHugh, the former chairman of Johns Hopkin's Psychiatry department. That doesn't sound like crazy loons to me.Doug:I didn't even say anything about the authors. Yet. David:
Oh, but you have. Before we've even started, you've described them as a small group of people (rather than physicians) who are trying to hijack science with political beliefs. You've already tried to establish that what they say doesn't represent science.

Doug:
That is just the general context. I'm going to have something to say about them, because it does matter who they are and how they have come to their "stunning" conclusions.

1. Human sexuality is an objective biological binary trait:"XY" and "XX" are genetic markers of health, not genetic markers of a disorder.

Doug:
Not sure where this is going. But we start with some Biology that you may, or may not remember. Again, wikipedia may be helpful for their section on XY sex-determination system. Are there more important "declarations"?

David:
Perhaps you slept through that lecture. I'll help you to understand, because I do understand biology. The paper is establishing that your sex is a fact of nature, not a malleable idea. Every cell in your body contains the same genetic material. Surgery, medications, the way you dress, or the way you see yourself doesn't alter that fact.

2. No one is born with a gender. Everyone is born with a biological sex. Gender (an awareness and sense of oneself as male or female) is a social and psychological concept; not an objective biological one.Doug:
Ok, now we start to see where we are headed. This "declaration" seems to be very black and white for a biological system that is very complex. Of course, chromosomes are instructions for building brains and bodies. The insertion of the word "objective" seems very unscientific. Neither the chromosomes nor the resulting sexual structures are strictly binary. And those, of course, don't need to necessarily align with brain structures or resulting behavior. Continue.

David:
So far, what they've said in both of the first two statements is identical to what you yourself said in an earlier blog about gender disorders. You should be happy; These board-certified pediatricians actually agree with you. Unless you are now arguing with yourself...

Objective is the opposite of subjective. Objective is indeed the scientific term.

And, with very rare exceptions (and there are always exceptions in nature) Chromosomes and sexual structures are, in fact, strictly binary.

3. A person's belief that he or she is something they are not is, at best, a sign of confused thinking.

Doug:
Ok, that doesn't sound scientific at all. They are saying that you are not what you believe you are, but what your biology dictates. "Confused thinking?" Is that a scientific psychological term? Who are these people? But let's hear the rest of their "declarations":

David:
I'll agree with you there. The group must have felt it was too much of a leap from that point moving forward, but the language is a bit "loose".

4. Puberty is not a disease and puberty-blocking hormones can be dangerous.5. According to the DSM-V, as many as 98% of gender confused boys, and 88% of gender-confused girls, eventually accept their biological sex after naturally passing through puberty.6. Children who use puberty blockers to impersonate the opposite sex will require cross-sex hormones in late adolescence. Cross-sex hormones (testosterone and estrogen) are associated with dangerous health risks including, but not limited to high blood pressure, blood clots, stroke and cancer.
Of course, the reason these statements are included is that the most recent and up-to-date research argues against the use of these drugs to change children physically, or to change their physical attributes to match their perceived gender, rather than their natural biology. As mentioned, when left alone, the vast majority of these children return to their biologic gender after puberty.

David:
Ah, now your starting to see the big picture. When you use these hormones in children, you may block or mask normal changes of puberty, or cause development of traits associated with the opposite sex. You may resemble the opposite sex, yet your biology remains unchanged. Hence the term "impersonate". But these hormones have very significant risks, especially when used long-term.

7. Rates of suicides are twenty times greater among adults who use cross-sex hormones and undergo sex-reassignment surgery, even in Sweden which is among the most LGBTQT-affirming countries.

Doug:
Wow! Using hormones and having sex-reassignment surgery causes suicides! If they would just stop doing that, I'm sure they would be fine.

David:
That doesn't strike me as quite the laughing matter. Children going through puberty are often emotionally labile (as we can all attest to!). Promoting gender confusion, and especially adding cross-sex hormones appears to make the matter much worse. The current political thinking of the left is that if only society would accept these individuals, they would be happy and not suicidal. The studies do not bear this out. As the paper mentions, even in Sweden, where transsexuals are accepted and protected, the suicide rates are the same. Of course, you probably do know better than the former chairman of Johns Hopkin's psychiatry department.

Doug:
No, I believe that their argument is laughable. They are arguing that it is the attempt to deal with their situation, rather than the bullying, violence, harassment, and being generally treated as outcasts, causes their suicides. Many can't even use the restroom in North Carolina without showing their papers.

David:
You're bias is plugging your ears and eyes. The studies (which this position paper is based on) show that the suicide rate doesn't change in Sweden, where transgenders are as accepted as they are ever going to get. The problem is not acceptance in the real world. The data indicates the problem is they are struggling to accept themselves in the real world.

Doug:
Why is it that the former chairman of the Johns Hopkins psychiatry department can't be wrong about this? There are many people that do argue with him, such as the rest of the American Academy of Pediatrics, which is the respected group.

David:
Right. Back to attacking the messenger. I would expect the AAP to be the "respected" group in your eyes, as their position papers recommend banning guns, mandating that guns in private possession must be locked in a safe at all times, and recommend full implementation of all aspects of Obamacare. Who would possibly argue with that?

Doug:
You could have made your argument without attempting to invoke the opinion of a minority group that has been characterized as "Christian lobbyists". But you didn't. You tried to use them to make the argument seem legit. Speaking of legit, I don't know anything about the AAP except that they have 60,000 members, and that they have denounced what the American School of Pediatricians claims.David:
Curious. You know nothing about a group, but if they agree with what you believe, they must be legit. If you don't agree with what they say, they're illegitimate. Nice argument. Now, moving on...8. Conditioning children into believing a lifetime of chemical and surgical impersonation of the opposite sex is normal and healthful is child abuse.
This is certainly strong language, and very concrete language, that should finally bring some sense to this ridiculous debate.

Doug:

Which debate is this? You forgot to mention that there was a debate, nor what the "other side" actually says. You did suggest that the "other side" must be liberals, and that anyone that doesn't agree with these "declarations" must be liberal.

David:
When it comes to transgender issues, I would argue that those who insist on the creation of laws protecting this group are liberals. As we gain more knowledge, we are finding that these individuals do not become mentally healthier with cross-sex hormone therapy or gender reassignment, especially in pre-pubescence.

Doug:

You can't just claim that if you believe X then you must be Y. If one does that, you don't get a chance to understand what the issues really are. As we gain more knowledge, we see that is a complex issue.

David:
At least you are now acknowledging the issue is complex. You've gone from a total dismissal of the subject, to arguing that we need to work to understand and gain knowledge for this complex issue. That's much better than your previous efforts to eliminate and shut down dissenting views, which is the current trend in Universities across the country.

One thing that makes this issue complex is the introduction of ethics. There are many economic studies that show that Medicare and Medicaid could save lots of money by rationing care to the elderly, or for rare cancers that are expensive to treat, but affect very few individuals. But ethically, no one would argue we should enact the results of those studies. In medicine, the ethics involved changes the way that the hard data is used. If you find it unethical to give a child dangerous medications (off-label) for a disorder that will resolve itself almost 90% of the time, you should speak out against those who are promoting that action.

Doug:
So, let's take a look at who the "American School of Pediatricians" is. It does sound professional! They describe themselves:

The American College of Pediatricians is a national organization of pediatricians and other healthcare professionals dedicated to the health and well-being of children. --- http://www.acpeds.org/about-us

The children... of course, the children. We must protect the children at all costs. Cool. But they have a particular method of how that must be done that isn't surprising: one father, one mother, no adoptions, and married. But they even go further: "This group knows that human life begins at conception and should be protected from that moment until the time of natural death – no abortions and no euthanasia. They also are aware that a child is best reared in a home that has both a mother and father who are the biological parents, love each other and love their children."

David:
So, you're arguing that there is no evidence and there are no studies that indicate that children do better in every measure in a two-parent household, where there is a mother and father who are married? Are you arguing that there are no studies that indicate a child does better (again, by almost any measure you choose) with their biological parents? You are wrong. The evidence is overwhelming. This does not say that there are no children that do well outside of these parameters, or deny that there are children that fair poorly living with their parents, but as a whole, children do best when they are within these parameters. I'm not sure why you would feel that a group of board-certified pediatricians would not be interested in protecting children. Once again, your attacking the messenger.

Doug:
We'll come back to their evidence shortly. But note that they don't say anything about the death penalty. Surely that must be an "unnatural death."

David:
Well, they are pediatricians, so they probably don't feel a great need to produce a position paper on the death penalty. I'm not aware that the death penalty affects children to a large degree.

Doug:
Maybe they are pediatricians. But they feel that they can comment on abortion, but not the death penalty? They feel like they can comment on euthanasia, but not the death penalty? That seems strangely specific, and completely arbitrary.

David:
Even Hillary noted unborn babies are "Unborn" children. That sound like a pediatric constituency for sure. You're right; Abortion is the death penalty for children.

Doug:
Ah, no it isn't. Like many of their "conclusions". They also oppose gay marriage. There aren't even any children involved in gay marriage, but they oppose it. Remember, they represent pediatricians. It does seem that they stray from their subject of supposed expertise, but only in some circumstances.

David:
Um, not to be too obvious, but it is usually children who get adopted. I'd like to offer you to another family, but I doubt we'll get any takers.

Doug:
So, let's look at how to make an argument based on very little, if nothing. This is the Art of the Argument. First, let's take a look at your original title "Gender Ideology Harms Children- It's Official." That sounds very conclusive. The use of "official" is the most interesting choice. "Official" frames the argument in a manner that places it above disagreement. But as we now see, this idea is only "official" in the sense that anything that this group writes on their blog is "officially from them"... which has no meaning.

David:
Your "argument" is not an argument at all. According to you, no one or any group can ever use the word "official" for anything. If the White House or the president enacts a policy, well, it isn't official. It's only what the White House says is official. That's nonsensical.

Doug:
Second, your original opening paragraph does a number of things. It gives the reader the framing for understanding the argument. It is "stunning". So, if you had any doubt before, it is ok, because this is shocking. And it is true that it would be stunning if it were true. It says that the "report" is based on "science." But of course it isn't. There is no data in this position paper. It is pure opinion. You give their opinion importance by claiming that it is a well-respected group ("American College of Pediatricians"). And you end with a "fact" that is far from a fact.

David:
You obviously have not taken the time to read the very short position paper. (You must have been spending too much time doing your exhaustive research on Wikipedia.) The paper has extensive footnotes on each of the bullet points. The conclusions were not assembled by some guy sitting in his Mom's basement. The Journal of Endocrinology and Metabolism, The FDA, The World Health Organization, and the American Psychiatric Association are all sources for the data used in this paper. I suppose they are all quacks and nut-jobs?

Doug:
Who is the "American College of Pediatricians"? Well, they are "American" because they are apparently made up of Americans. We could put "American" in our title too. Are they a "College"? Not in any sense that we understand it. They are simply a not-for-profit corporation. That's it. We could be a college too. Are they all pediatricians? No, anyone can join for $50. And you don't even have to be an American. Nor a pediatrician. So, they are not all pediatricians after all. How many of them are there? Their membership has been estimated "between 60 and 200 members." So when you complain that all of these people are really "physicians", you are wrong.

The supposed well-respected group is far from well-respected.

David:
It would appear they meet all of the same requirements of professional groups that you yourself belong to. And I believe the ACP has more members than some of your professional associations. They have a large Board of Directors, which is the photo you've included. Using a statement declaring them "far from well-respected" as your final comment seems to fall into the same problem you just commented on: Using a fact that is far from a fact.

Doug:
But you are right: one can't dismiss the message based on where the message comes from. On the other hand, if the group were well-respected, the message can't be dismissed without examination. How does a group become well-respected? Can you get respect because you have a degree? No, of course not. You earn it: you get respect through your past actions. This group was created because they have axes to grind:

Have you felt a sense of frustration lately that your current professional medical association is investing your annual dues to promote social agendas that do not reflect your personal values and convictions? Have you felt that recent policy statements have emanated more from political persuasion than from evidence-based science?

All you need is a feeling, an opinion, a gut reaction to your current association, and you can join (with $50). But are they well-respected? No. If you read their wikipedia page, you'll find many links to disturbing behavior from this group.

David:
Before, this discussion seemed a bit contentious. Now, I'm just laughing. You're really going to use Wikipedia and the Huffington Post to support your case, to dispute cohort-studies from scientists in Sweden? (snicker)

As I have already mentioned, this group split from the AAP when that group took a decidedly liberal turn with their positions on gun bans and the like. I'm sure that if a professional organization you belonged to began promoting conservative values you'd go looking for another group to join.

Doug:
Now that there is a group, we go looking for data, anything, to support our gut reaction. One report that the group uses is the New Family Structures Study. This data has been criticized by academics and medical organizations. You can claim "the evidence is overwhelming" but that is absolutely false.

David:
It seems you have followed the same argument game plan you were just criticizing. You've searched through the footnotes of the paper to find anything that supports your gut reaction. I note you are not critiquing the FDA, the DSM-V, or WHO. Their studies and data are also used to reach conclusions in this paper.

You seem to be making an argument that a group of scientist, with a political agenda, can use scientific data to drive a political narrative. Hmm. We may have to revisit this topic when we discuss global warming.....Doug:
How can one defend an argument? You could try to dismiss your critics by putting words into their mouth. For example, you could claim that your opponent too-easily dismisses your argument. You can claim that your critic thinks your argument is "nonsensical tripe" when they really did weigh the claims carefully. You can invoke dog whistles to taint the argument ("you are a Saul Alinsky").

David:
Or, you could try to change the entire discussion (including the title) to one about how to argue, rather than focusing on data that indicates medicating children with gender-identity disorder is dangerous, harmful, and in the long-term, unnecessary.

Doug:
But in a big sense, you won the argument because we are giving this small group of angry people a platform to spread their unscientific views by discussing them. We shouldn't do this. It doesn't help understand the issues at all.

David:
And that is how the liberal left argues: "Silence dissenting or differing views so we can better understand the issues! The issue is decided! Anyone who disagrees is a science denier! Your argument isn't valuable to me, so I won't consider it. That way, I can become more enlightened."
This is how we've ended up with a new generation of college grads who feel "physical pain" if anyone disagrees with them. Well, I hope you're in your safe-space, because this is the point in the argument where I introduce all of the same data, but from a traditional, liberal source. A source beyond your reproach:

In this story, PBS lists the dangers of these drugs, including some that were not even mentioned in the ACP position paper (like sterility). The doctors prescribing these medications (which it is noted they are using off-label) feel there is more benefit than risk to these children, but then repeatedly state that they have absolutely no idea what the risks even are. No studies have been done. These doctors, at the "Gender and Sex Development Program", are experimenting on these children.

So, it seems that the ACP isn't just a crazy, loony group of old, angry people spouting bad information. The data is out there. The data is real. But liberals who are enamored with the idea of transgenders are willing to bypass traditional medical research, and just move ahead and see what happens.....to children! I say that's wrong, and a group of pediatricians decided to take a stand against it as well.

Doug:
I don't want doctors "taking a stand" based on their feelings; I want doctors that do good research, and follow where the science leads them. Otherwise, it is easy to see that their biases cloud their judgment. Who to trust: 60,000 unbiased doctors? Or 60 biased ones? You decide.

David:
Nice argument summary. You try to frame the argument that this group uses no science to reach their conclusions, even though that clearly is not the case. You appeal to "good" research, and insinuate this paper doesn't use any, even though liberal news sites use the same data. And then you unilaterally claim the group you agree with is unbiased, yet the group you disagree with is, of course, biased. Finally, more than 75% of Americans believe in God. Only 2% are atheists (mostly white males). So, by your standard, who does that make right?

Doug:
I take these groups at their word: the AAP (66,000 members) is unbiased because that is what they claim. The ASP (60 members) is biased because that is what they claim ("trust your feelings"). Actually, U.S. unbelievers are up to 23%, and rising. But I don't doubt the ASP because they have fewer members; I don't believe them because they are biased. Their small number of members is a side-effect of their fringe beliefs.

David:
Well then, I claim to be unbiased. I didn't realize it was that easy to win you over.
Rather than rely on the infallible Wikipedia, I called the ACP. The numbers are wrong and outdated, by a long shot. The other interesting thing I learned, and validated, is that the AAP has 15 board members that decide what positions they take. The ACP has their entire membership vote on the issues, and requires 75% approval before taking a position. Assuming the entire AAP agrees with their positions is wrong, but the majority of members of the AAP (which has only been around for 14 years, rather than 87) believe in the science behind their positions. Most are also members of the AAP, so some of the ACP numbers are duplicates. If your claim is that the ACP is a bunch of loons, then the AAP also has a bunch of loons as members. Neither is the case.
You don't believe them because you choose not to believe them, and therefore, they shouldn't be discussed. Your argument style is consistent with what we've seen coming out of colleges and universities of late: If something doesn't fit with your ideology, then it is not only wrong, but shouldn't be allowed into the debate at all. The goal is not to teach young adults "how to think", which is the common claim of higher education. The real goal is to teach them "how to think correctly", which means "like a good liberal". Why else would you choose to eliminate debate?
That may make for an effective argument style, but in the end, it actually hurts honest debate.